Remote Healthcare Member Support Specialist

brightonhealthplansolutions; Chapel Hill (NC); Remote; USD 36,000 - 47,000; Full time

Job summary

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative to assist members, providers, and facilities with benefits, eligibility, and appeals. This remote role requires handling inbound calls and delivering empathetic, accurate support during 8:00 AM–5:30 PM EST shifts Monday–Friday.

You will update member files, ensure first contact resolution where possible, and collaborate with teams to improve service delivery.

Qualifications

• Experience in a high-volume call center handling medical inquiries and appeals.
• Experience with medical specialties and call center responsibilities.
• Previous experience in a physician's office or hospital-based practice.

Responsibilities

• Handle inbound calls from members, physicians, hospitals, and others.
• Listen to and address customer needs and concerns empathetically.
• Answer questions about, network participation
• Ensure first contact resolution when possible.
• Update customer files and communicate effectively with teams.
• Transfer misdirected requests and offer solutions to non-routine issues.
• Contribute to customer satisfaction and business improvement.
• Collaborate with other team members.
• Adapt responses to caller understanding.
• Educate callers and validate their understanding.
• Support projects and other departments as directed by management.

Skills

Call center experience

Communication skills

Time management

HIPAA knowledge

Empathy

Attention to detail

Multichannel support

Problem solving

Flexible/adaptable

Microsoft Office

Education

High School diploma

Some college / business school

Job description

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative to assist members, providers, and facilities with benefits, eligibility, and appeals. This remote role requires handling inbound calls and delivering empathetic, accurate support during 8:00 AM–5:30 PM EST shifts Monday–Friday.

You will update member files, ensure first contact resolution where possible, and collaborate with teams to improve service delivery.